D’Amato: Prison is no place for the mentally ill

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That crude household tool, its stiff cracking sound as it is pulled away from the roll and used to bind Ashley Smith’s wrists together.

“You’re hurting my hands!” shouts the teenager from behind two masks that have been tied over her head so that she can’t spit at anyone. “Ow! It hurts!”

These few minutes of video are taken from 2007, six months before Smith died in jail in Kitchener. She is on a plane, being transferred from a jail in Saskatoon.

The co-pilot and two guards are standing over Smith. “Don’t bite me,” he says.

“I’m not,” Smith responds.

“It’ll get worse if you do,” he continues. “I’ll duct-tape your face. We’re at 33,000 feet. I’m not taking any risks. Do I make myself clear?”

And then she is quiet.

This sad moment in Smith’s achingly sad life was shown for the first time this week. There are other videos that the federal agency didn’t want you to see, including one where several guards come into her cell in full riot gear including gas masks, and give her injections to tranquilize her. It is painful to watch.

Smith’s short, tortured life, so much of it spent in jail, is the subject of an inquest, five years after her death.

Adopted as a baby by a New Brunswick couple, Smith was in her early teens when she started acting up. She was arrested for the first time when she was 13, for assault and causing a disturbance. She pulled fire alarms, made harassing phone calls and was jailed at 15 after she threw crab apples at a mail carrier.

Once in jail, she was defiant, difficult, and tried to harm herself. Staff responded by restraining her physically, forcing medication into her, and keeping her in long periods of isolation.

Smith died in Kitchener’s Grand Valley Institution for Women by strangling herself with a piece of cloth. Guards were watching her, but had been instructed not to intervene until she had stopped breathing. By then, it was too late.

The inquiry into Smith’s death, a full five years after she killed herself, has been delayed by legalistic arguments.

But at the core of it all is the issue that Smith — like so many people who end up in jail — was mentally ill and needed treatment. And what she got in jail for that mental illness was a mixture of cruel punishment and the crudest of tools. Like that roll of duct tape.

It’s easy to point fingers from the safety of one’s living room, and I’m sure Smith was a nightmare for guards. But we already know that the tactics they used would have made her condition worse, not better.

We already know, for example, that physical restraints are dangerous. At Grand River Hospital, the policy states they should be used as a last resort and removed as quickly as possible. Valerie Johnston-Warren, a clinical nurse specialist in the mental health program, says they can be “very traumatizing.” physically and emotionally.

“Sometimes it can actually escalate if you jump into using restraints too quickly,” she told the Record’s health reporter, Johanna Weidner.

Another expert, psychiatrist Dr. John Bradford, says that “a correctional facility is the worst possible setting for a person with serious mental illness.”

We know so little, still, about mental health. But we do know that when criminals with mental illness are placed in special centres with a wide range of medical treatments, they do better. They are less likely to re-offend when they leave. That’s what a secure treatment facility in Brockville, co-founded by Bradford, has been able to show.

Why could we not have had that kind of treatment for Ashley Smith? Couldn’t we, in 2012, have done better for her and others like her?

In the grim story of Ashley’s short life, a little light has entered. The story of the abuse she endured refuses to die down, and it looks as if the federal government is finally willing to work toward a better solution. On Thursday, Prime Minister Stephen Harper publicly criticized correctional authorities for their “completely unacceptable” handling of Smith. He said the government would look at whether more money is needed for mental health care in prisons. Perhaps the inquest can show the way. That’s not much, and it won’t bring Smith back to her family, but it is something.